Insurance Setback

The final frontier. Deciding when, if and how.
Fundle
Posts: 19
Joined: Fri Dec 22, 2017 9:59 pm
Location: Eastern PA

Insurance Setback

Postby Fundle » Fri Mar 02, 2018 11:24 pm

I was eagerly looking forward to my penile implant surgery, originally scheduled for yesterday in Philadelphia, PA. I jumped through all the hoops, had clearance from my family doctor and my cardiologist, thought I was ready to go. But three weeks ago I got a call from my surgeon's office saying my medical insurance had declined authorization. Needless to say, that was a blow. So for the time being I had to cancel my presurgery admission testing and drop off the surgeon's schedule.

The good news, however, is that it should be covered under Medicare. And I'm in the process of switching from private insurance to Medicare, so I'll be contacting the surgeon as soon as Medicare is fully active, and get back on the schedule. I'm not sure how long that will take, but hopefully not more than a month or two.

Have any of you (in the US) had this surgery under Medicare? Any issues I should be aware of?
Age 66. Originally scheduled for penile implant surgery March 1, 2018 with Dr. Garber in Phila, but delayed for insurance reasons. ED for 20 years; tried testosterone replacement, ED meds, pump, tri-mix injections. All helped for a time, but no longer.

Anonymous3
Posts: 1307
Joined: Thu Aug 03, 2017 9:43 pm

Re: Insurance Setback

Postby Anonymous3 » Sat Mar 03, 2018 3:20 am

My secondary insurance fucked me over. They (GEHA) does not cover sexual impotence or inadequacy or anything related to it. But by law they have to pay for a fucking sex change. My Dr is good for all the testing and surgery I owe 300. Hecwrote a bunch of stuff off. I think Medicare authorised 13k and paid 10k.

I have a post about it

viewtopic.php?f=6&t=9049&p=71264&hilit=Insurance#p71264


I think all of that this has happen to should file a discrimination law suite. The law says you can not discriminate because of sex. But it would not would not work since we are men and no what gender we are and want to stay that way. You can thank Congress for it. They are the ones that loved The fucked up Affordable Care Act, that does not apply to them

DonDon
Posts: 71
Joined: Mon Sep 11, 2017 5:20 pm

Re: Insurance Setback

Postby DonDon » Sat Mar 03, 2018 8:30 am

Medicare and Advantage plan through Humana paid all but my $200 co-pay.
Aug'15: RP NON nerve-sparing on Rt. Pills, vac pump, injections: Injections were best, about 50%. Aug'17: Penile pain and headaches. Implant: AMS CX 18 cm+2 cm. (Undersized! :x ) Asked for LGX! Ochsner Hospital, New Orleans, LA Still working great.

nudist
Posts: 154
Joined: Thu Jun 08, 2017 7:44 pm

Re: Insurance Setback

Postby nudist » Sat Mar 03, 2018 9:10 am

hturner12 wrote: You can thank Congress for it. They are the ones that loved The fucked up Affordable Care Act, that does not apply to them


my roommate has had 2 different types of cancer. without the affordable care act, she would have no insurance. is that what you find preferable?
updated: 70 y.o., implanted with titan nov. 3 by Dr. Brady in orlando to correct peyronies. 20 cm with 3 cm RTEs. due to the severity of the peyronies, some internal excisions were made scrotally, recovery will probably take a little longer.

David_R
Posts: 2145
Joined: Mon Nov 02, 2015 1:03 pm

Re: Insurance Setback

Postby David_R » Sat Mar 03, 2018 10:24 am

Sometimes a doctor's office will go to bat for you with the insurance company, saying that if they cover breast reconstruction after a mastectomy (the reconstruction being a procedure that is not to prevent death but instead is to improve life), then they should also cover a penile implant. Hope someone goes out to confront them on this (most insurance covers breast reconstruction, I understand).

Anonymous3
Posts: 1307
Joined: Thu Aug 03, 2017 9:43 pm

Re: Insurance Setback

Postby Anonymous3 » Sat Mar 03, 2018 11:45 am

nudist wrote:
hturner12 wrote: You can thank Congress for it. They are the ones that loved The fucked up Affordable Care Act, that does not apply to them


my roommate has had 2 different types of cancer. without the affordable care act, she would have no insurance. is that what you find preferable?



That is the exception Congress is the ones that determined tha sexual dysfunction d8d not gave to be covered

Xomanow
Posts: 403
Joined: Mon Dec 14, 2015 9:03 pm

Re: Insurance Setback

Postby Xomanow » Sat Mar 03, 2018 12:01 pm

Medicare A&B paid for my entire implant......that was almost enough to give me an erection right there......
Implanted Jan 4 2017 by Dr. Eid - 70 yo and single...ED gradually over 15 yrs...tired of pills, injections, cock rings....happy with my choice and results. Titan OTR - one 20cm cylinder - one 20cm+1 RTE...."got a rocket in my pocket"....

ocitgo
Posts: 397
Joined: Wed Jan 01, 2014 8:48 pm
Contact:

Re: Insurance Setback

Postby ocitgo » Sun Mar 04, 2018 6:05 am

Kaiser and medicare covered 100%.
ocitgo (Bob F), Bremerton, WA
Implanted 11/13/2017 AMS 700LGX 15 cm, leak, 3 cm rear tip
Implanted 06/17/2019 AMS 700LGX 18 cm, 1.5 cm rear tip

Tsanchez12369
Posts: 227
Joined: Fri Dec 23, 2016 7:52 pm
Location: SAN Francisco

Re: Insurance Setback

Postby Tsanchez12369 » Mon Mar 05, 2018 12:17 pm

Hugh, I’m sorry for your predicament. Fortunately, Medicare pays. Affordable care act has decreased the number of conditions that insurance companies can exclude...we need more of that not less. Also, please don’t let the profit driven corporations divide and conquer...our brothers and sisters that need a sex change operation are certainly entitled to one as are those of us that need an implant.
Sept 11, 2018: excision, grafting (human cadever tissue) and implant. Doc is Dr Edward Karpman in Mountain View, surgery at El Camino Hospital, LOS Gatos CA. AMS 700 CX infrapubic 18 cm + 3 cm RTE. http://www.peyroniesforum.net/index.php

Anonymous3
Posts: 1307
Joined: Thu Aug 03, 2017 9:43 pm

Re: Insurance Setback

Postby Anonymous3 » Mon Mar 05, 2018 5:19 pm

Tsanchez12369 wrote:Hugh, I’m sorry for your predicament. Fortunately, Medicare pays. Affordable care act has decreased the number of conditions that insurance companies can exclude...we need more of that not less. Also, please don’t let the profit driven corporations divide and conquer...our brothers and sisters that need a sex change operation are certainly entitled to one as are those of us that need an implant.

That not what I am saying. If they are required to pay for that operation then they should also be required to pay for our operations. We are being discriminated against because we are men.


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